Provider Demographics
NPI:1245500636
Name:FARMER, ERICA (LPC-S)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1521
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-1521
Mailing Address - Country:US
Mailing Address - Phone:979-203-0400
Mailing Address - Fax:
Practice Address - Street 1:105 E MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-3785
Practice Address - Country:US
Practice Address - Phone:979-203-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional